Influence of two different perfusion systems on inflammatory response in pediatric heart surgery.
Ann Thorac Surg
; 75(3): 919-25, 2003 Mar.
Article
en En
| MEDLINE
| ID: mdl-12645717
ABSTRACT
BACKGROUND:
This study tests the hypothesis that a cardiopulmonary bypass system that combines complete heparin-coating, a centrifugal pump, and a closed circuit in comparison with a conventional system (uncoated system, roller pump, and hard shell venous reservoir) attenuates the inflammatory response in pediatric heart surgery.METHODS:
In a prospective randomized controlled clinical study 40 consecutive children weighing 10 kg or less were included and divided into two groups. Concentrations of complement proteins (C3a, sC5b-9, C4d, and Bb), granulocyte degranulation products (polymorphonuclear [PMN] elastase), and proinflammatory cytokines (tumor necrosis factor [TNF]-alpha, interleukin [IL]-6, and IL-8) were measured.RESULTS:
C3a and sC5b-9 concentrations were lower (C3a, p < 0.001; sC5b-9, p = 0.01) in the combined (heparin-coated/centrifugal pump/closed reservoir) group, the peak values being 58% and 37% of conventional group values. The Bb- and C4d-fragment values indicated activation of the complement system through the alternative pathway in both groups. PMN elastase concentrations were lower (p = 0.02) in the combined group, the peak values being 43% of conventional group values. There were no significant intergroup differences regarding TNF-alpha, IL-6, or IL-8 concentrations.CONCLUSIONS:
The use of a fully heparin-coated system, a centrifugal pump, and a closed circuit during CPB in children (10 kg or less) leads to a lower degree of complement activation and PMN elastase release compared with a conventional system.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Heparina
/
Puente Cardiopulmonar
/
Síndrome de Respuesta Inflamatoria Sistémica
/
Mediadores de Inflamación
/
Materiales Biocompatibles Revestidos
/
Cardiopatías Congénitas
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2003
Tipo del documento:
Article
País de afiliación:
Suecia